Risk factors for oropharyngeal dysphagia in cardiovascular diseases

Almeida, Tatiana Magalhães de; L, Gomes; Afonso, Débora; Magnoni, Daniel; Mota, Isabela Cardoso Pimentel; França, João Ítalo Dias; Silva, Roberta Gonçalves da

doi:10.1590/1678-7757-2019-0489

Cited by 11 publications

(11 citation statements)

References 25 publications

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“…Among clinical predictors, the GCS <13 at admission and in cardiovascular disease were significantly associated with dysphagia in SDH. This is in line with previous studies where cardiovascular disease are identified as predisposing risk factor for dysphagia (15). Furthermore, our data show a significant correlation between dysphagia and the severity of head trauma expressed by GCS.…”

Section: Discussionsupporting

confidence: 93%

Neurogenic Dysphagia in Subdural Hematoma

et al. 2022

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IntroductionDysphagia is a common and severe symptom of traumatic brain injury (TBI) affecting up to 78% of patients. It is associated with pneumonia, increased morbidity, and mortality. Although subdural hematoma (SDH) accounts for over 50% of TBI, the occurrence of dysphagia in this subtype has not been investigated yet.MethodsAll patients with SDH admitted to the author's institution between the years 2007 and 2020 were included in the study. Patients with SDH and clinical suspicion for dysphagia received a clinical swallowing assessment by a speech and language pathologist (SLP). Furthermore, the severity of dysphagia was rated according to swallowing disorder scale. Functional outcome was evaluated by the Glasgow outcome scale (GOS).ResultsOut of 545 patients with SDH, 71 patients had dysphagia (13%). The prevalence of dysphagia was significantly lower in the surgical arm compared to the conservative arm (11.8 vs. 21.8%; OR 0.23; p = 0.02). Independent predictors for dysphagia were GCS <13 at admission (OR 4.17; p < 0.001), cardiovascular disease (OR 2.29; p = 0.002), and pneumonia (OR 2.88; p = 0.002), whereas the operation was a protective factor (OR 0.2; p < 0.001). In a subgroup analysis, right-sided SDH was an additional predictor for dysphagia (OR 2.7; p < 0.001). Overall, patients with dysphagia improved significantly under the SLP treatment from the initial diagnosis to hospital discharge (p < 0.01). However, a subgroup of patients with the most severe grade of dysphagia showed no significant improvement. Patients with dysphagia had significantly worse outcomes (GOS 1–3) compared to those without dysphagia (48.8 vs. 26.4%; p < 0.001).ConclusionDysphagia is a frequent symptom in SDH, and the early identification of dysphagia is crucial regarding the initiation of treatment and functional outcome. Surgery is effective in preventing dysphagia and should be considered in high-risked patients.

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Section: Discussionsupporting

confidence: 93%

Neurogenic Dysphagia in Subdural Hematoma

et al. 2022

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“…Many studies have described the incidence of dysphagia, with the duration of endotracheal intubation after cardiac surgery being a strong predictor of dysphagia [5,7,9,10]. In addition, our study showed that alternative nutrition at the start of rehabilitation was signi cantly associated with MV duration.…”

Section: Discussionsupporting

confidence: 59%

“…A review of the literature on post-extubation dysphagia reveals a variety of causes without consensus [3]. In cardiovascular disease, previous studies have demonstrated that stroke, malnutrition, prolonged orotracheal intubation, and advanced age are predictive risk factors for dysphagia [9][10][11]. However, most studies have reported the incidence of postoperative dysphagia.…”

Section: Introductionmentioning

confidence: 99%

Investigation of inhibiting factors of dysphagia rehabilitation in cardiovascular patients treated with invasive and non-invasive mechanical ventilation

Nakamura

Kurosaki

Baba

et al. 2022

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Objectives To clarify the factors inhibiting dysphagia rehabilitation in cardiovascular patients treated with invasive and non-invasive mechanical ventilation (MV). Methods The subjects were patients with dysphagia and cardiovascular disease treated with MV who were admitted to our hospital between April 2019-December 2021. Age, sex, walking ability, Geriatric Nutritional Risk Index (GNRI), primary heart disease, Charlson Comorbidity Index (CCI), invasive or non-invasive MV, Sequential Organ Failure Assessment (SOFA) at the start of MV, duration of MV, days from the withdrawal of MV to the start of rehabilitation, Functional Oral Intake Scale (FOIS) at the start of rehabilitation and discharge, length of hospital stay, pneumonia after the start of rehabilitation, and death during hospitalization were retrospectively surveyed. Results Ninety-six of the 105 patients survived, and 37 patients recovered from dysphagia. Twenty-two patients needed alternative nutrition at the start of rehabilitation, which was significantly associated with the duration of MV, length of hospital stay, and pneumonia after the start of rehabilitation. Death during hospitalization was significantly associated with lower GNRI scores, a history of chronic pulmonary disease, lower FOIS scores at the start of rehabilitation, and pneumonia developed during hospitalization. Dysphagia at discharge was significantly associated with older age, walking disability, lower GNRI scores, congestive heart failure, higher CCI scores, non-invasive MV, and higher SOFA scores. Conclusions The factors inhibiting dysphagia rehabilitation in cardiovascular patients treated with MV differed between the initial evaluation and outcomes and between vital and functional outcomes. Nutritional risk is a common risk factor for vital and functional outcomes.

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“…Dysphagia and malnutrition are two major issues in the elderly with a negative impact on several pathological conditions, including cardiovascular disorders, cognitive status impairment, immune system downregulation, pressure ulcers, and skeletal muscle system worsening [ 197 , 198 ]. Therefore, effective interventions aimed at improving the nutritional intake and counter malnutrition are mandatory not only to prevent dysphagia-related complications (such as aspiration pneumonia) but also to improve the general health status and the HRQoL of older patients [ 199 ].…”

Section: Oropharyngeal Rehabilitationmentioning

confidence: 99%

Sarcopenic Dysphagia, Malnutrition, and Oral Frailty in Elderly: A Comprehensive Review

et al. 2022

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Frailty is a highly prevalent condition in the elderly that has been increasingly considered as a crucial public health issue, due to the strict correlation with a higher risk of fragility fractures, hospitalization, and mortality. Among the age-related diseases, sarcopenia and dysphagia are two common pathological conditions in frail older people and could coexist leading to dehydration and malnutrition in these subjects. “Sarcopenic dysphagia” is a complex condition characterized by deglutition impairment due to the loss of mass and strength of swallowing muscles and might be also related to poor oral health status. Moreover, the aging process is strictly related to poor oral health status due to direct impairment of the immune system and wound healing and physical and cognitive impairment might indirectly influence older people’s ability to carry out adequate oral hygiene. Therefore, poor oral health might affect nutrient intake, leading to malnutrition and, consequently, to frailty. In this scenario, sarcopenia, dysphagia, and oral health are closely linked sharing common pathophysiological pathways, disabling sequelae, and frailty. Thus, the aim of the present comprehensive review is to describe the correlation among sarcopenic dysphagia, malnutrition, and oral frailty, characterizing their phenotypically overlapping features, to propose a comprehensive and effective management of elderly frail subjects.

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Risk factors for oropharyngeal dysphagia in cardiovascular diseases

Cited by 11 publications

References 25 publications

Neurogenic Dysphagia in Subdural Hematoma

Neurogenic Dysphagia in Subdural Hematoma

Investigation of inhibiting factors of dysphagia rehabilitation in cardiovascular patients treated with invasive and non-invasive mechanical ventilation

Sarcopenic Dysphagia, Malnutrition, and Oral Frailty in Elderly: A Comprehensive Review

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